Cluster Headache Treatment

Some people—overwhelmingly men—suffer “cluster headaches,” very severe migraines localized around or behind one eye that typically strike several times in rapid succession over a few days. Cluster headaches usually begin between age 20 and 40. They often strike at night, last about an hour, and are accompanied by agitation, nasal stuffiness, sensitivity to light, and tearing on the affected side.

Like migraines, cluster headaches often have triggers, explains neurologist Robert Smith, M.D., founder of the Headache Center at the University of Cincinnati, including: stress, smoking, alcohol, perfumes, gasoline and other chemical fumes.

Mainstream doctors treat cluster headaches like migraines. Complementary practitioners typically do the same. These treatments often help. In addition, these approaches have shown benefit in treating cluster headaches:

• Melatonin. Melatonin is a hormone, available over the counter as a supplement, that often helps treat insomnia and jet lag. Researchers in Milan, Italy, noted an unusual decrease in night-time melatonin levels in people with cluster headaches. They gave 20 sufferers either a placebo or melatonin (10 mg a day in the evening) for two weeks. The placebo group recorded no changes in headache frequency, but those who took melatonin had significantly fewer cluster headaches, and used less medication.

• Red pepper. Capsaicin is the fiery element in red or cayenne pepper. It’s also hot medically. When rubbed on the skin in an ointment, it blocks substance P, a neurotransmitter involved in pain perception. In one study, cluster headache sufferers were given either a placebo ointment or one containing capsaicin, and were told to apply it for 15 days in their noses on the side where they experienced their headaches. During the second week, the capsaicin users reported a significant decrease in their headache pain. Capsaicin ointments are available over the counter.

• Oxygen. Some years ago, doctors noticed that air travel seemed to trigger cluster headaches. Commercial aircraft are pressurized to the atmosphere at 8,000 feet, so airplane air contains less oxygen than the air most of us generally breathe. If a low-oxygen environment triggered cluster headaches, researchers thought that extra oxygen might help. Turns out, it does. Inhaling 100 percent oxygen through a face mask can be “very helpful,” Dr. Smith says.